Permanent and removable implants for the brachytherapy of brain tumors
Stem Cell Transplantation
Thirty-seven patients harboring primary or metastatic brain tumors were treated with 40 implantations of radioactive sources (192Ir, 198Au, or 125I) using stereotactic neurosurgical techniques. Most tumors had recurred after surgery, whole brain irradiation, and treatment with all feasible chemotherapeutic agents. Sixteen of the 40 implants were permanent; 24 were mounted in plastic catheters for removal after the desired dose had been delivered. One or more sources were placed in each tumor to deliver 3500-7350 rad to the tumor's periphery for 198Au, 4,000-12,000 rad for 192Ir, and 3,000-20,000 rad for 125I. Three of the six patients treated with 192Ir had objective responses for 2, 4, and 12 months, and two stabilized for 8 and 11 months. Seven of the 11 patients treated with 198Au were evaluable: three responded for 3, 5, and 37 + months, one deteriorating patient with a recurrent tumor stabilized for 6 months, and two deteriorated despite treatment. One patient received an interstitial "boost" dose with 198Au, after whole brain irradiation and stabilized for 15 months before developing spinal metastases. Six patients received permanent implants with low activity 125I. Three of these patients had glioblastomas or anaplastic astrocytomas; all continued to deteriorate despite the interstitial irradiation, presumably because the does rate was too low. One patient with a low-grade astrocytoma (optic chiasm) responded dramatically to permanent, low activity 125I implants (11 + months). Another (hypothalamic glioma) had a permanent 125I implant, responded, and was stable at 9 months when external irradiation was administered. One patient with a suprasellar "teratoid" tumor stabilized for 10 months. Seventeen removable high activity 125I sources were implanted in 15 patients who had recurrent malignant primary or metastatic tumors. Twelve of these patients are currently evaluable; eight patients responded for 4 to 8 months, three patients stabilized for 3,7, and I1 months, and one patient harboring a metastatic melanoma failed to improve despite two implants 8 weeks apart. © 1981.
Digital Object Identifier (DOI)
Additional Document Info
has global citation frequency